scholarly journals Massive Cerebral Gas Embolism under Discectomy due to Hydrogen Peroxide Irrigation

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Junjie Zhang ◽  
Chengliang Zhang ◽  
Jianqin Yan

Massive cerebral and spinal gas embolism occurs rarely as a complication of discectomy. We report a 54-year-old female who had undergone a discectomy (L3/4 and L4/5) under epidural anesthesia in a local hospital developed multiple massive gas embolisms. At closure, surgeons irrigated the incision wound with hydrogen peroxide. Soon after the irrigation, the patient suddenly developed tachycardia, hypotension, and rapid oxygen desaturation. Subsequently, patient progressed into unconsciousness and right hemianopsia quadriplegia. Computed tomography (CT) scan showed multiple hypointensity spots around the brain due to cerebral gas embolism, which indicated the pneumoencephalos. The likely mechanism was the absorption of hydrogen peroxide into blood. When the amount of oxygen evolved exceeded its maximal blood solubility, venous embolization occurred. Though the patient was treated with supportive treatments and hyperbaric oxygen, she did not get full recovery and was left with severe long-term cerebral injury.

2021 ◽  
Vol 23 (2) ◽  
pp. 14-24
Author(s):  
V. A. Lukyanchikov ◽  
I. M. Shetova ◽  
V. D. Shtadler ◽  
N. E. Kudryashova ◽  
G. K. Guseynova ◽  
...  

The study objective is an assessment of long-term results of cerebral revascularization performed in the acute period of subarachnoid hemorrhage due to rupture of cerebral aneurysms.Materials and methods. This cross-sectional study includes 74 patients, operated in N.V. Sklifosovsky Research Institute for Emergency Medicine in the acute period of aneurysmal subarachnoid hemorrhage. Patients were divided into two groups. The first group contained patients with EC—IC bypass performed in the acute period of aneurysmal subarachnoid hemorrhage. The Control group contained patients without bypass. In the long-term period, 11 patients were examined. Computed tomography of cerebral vessels, duplex ultrasound examination of the aortic arch, brachiocephalic arteries and intracranial vessels, transcranial Doppler ultrasonography with a breathing function test, single-photon emission computed tomography of the brain followed by stress test with acetazolamide, Modified Renkin Scale, Mini-Mental State Examination, Montreal Cognitive Assessment, Index Bartel, The Hospital Anxiety and Depression Scale, Holms-Rahe were performed. For descriptive results, a mathematical model was used.Results. The best treatment outcomes in severe patients with subarachnoid hemorrhage and cerebral ischemia were observed when performing simultaneous clipping of the aneurysm and EC-IC bypass (57.1 % versus 41.0 %) there was no statistically significant difference in outcomes. EC-IC bypass functioned in 37.5 % of cases. The rate and acceleration of the fall in volumetric blood flow and the passage of blood from the aortic bulb to the cerebral arterioles affect the perfusion values in the region of the brain concerned. Evaluation of long-term results of simultaneous interventions revealed persistent disturbances in the regulation of cerebral blood flow at the microcirculatory level. Patients with EC-IC bypass had a higher level of cognitive function and stress potential.Conclusion. The results of this study showed us the necessity for a comprehensive exploration of cerebral blood flow.


2019 ◽  
Vol 40 (2) ◽  
pp. 246-262 ◽  
Author(s):  
Qiang Zhao ◽  
Tao Yan ◽  
Michael Chopp ◽  
Poornima Venkat ◽  
Jieli Chen

Stroke is a leading cause of mortality and morbidity, with long-term debilitating effects. Accumulating evidence from experimental studies as well as observational studies in patients suggests a cross talk between the brain and kidney after stroke. Stroke may lead to kidney dysfunction which can adversely impact patient outcome. In this review article, we discuss the epidemiology and mechanisms of brain–kidney interaction following ischemic stroke. Specifically, we discuss the role of the central autonomic network, autoregulation, inflammatory and immune responses, the role of extracellular vesicles and their cargo microRNA, in mediating brain–kidney interaction following stroke. Understanding the bidirectional nature of interaction between the brain and kidney after cerebral injury would have clinical implications for the treatment of stroke and overall patient outcome.


2019 ◽  
Vol 34 (1) ◽  
pp. 92-97
Author(s):  
Yu. M. Portnov ◽  
S. E. Semenov ◽  
I. D. Syrova ◽  
I. V. Sigitov

Aim. To assess the preoperative morphological state of the brain and the state of cerebral circulation in patients referred for coronary bypass surgery to identify predictors of long-term cerebral disorders.Material and Methods. The study included 33 male patients, divided into 2 groups according to the presence or the absence of distant neurological complications 5 years after surgery. All patients underwent non-contrast computed tomography of the brain and perfusion computed tomography. Computed tomography was repeated 5 years after surgery.Results. The perfusion indices in all measurement zones in patients of the two groups did not significantly differ. Significant differences in width of the third ventricle and ventricular-cranial index between patients of groups 1 and 2 were not identified. The incidence rates of leukoaraiosis significantly differed: leukoaraiosis was detected significantly more frequently in group 2 (78% of cases) than in patients of group 1 (31%), p=0.0455.Discussion. The dimensions of the brain cavity system and the preoperative state of the microcirculatory blood flow were not predictors of long-term postoperative neurological disorders. Five years after surgery, patients of group 2 showed clinical and morphological signs of past ischemic changes, which were not detected in patients of group 1 suggesting that leukoaraiosis was an unfavorable prognostic indicator of postoperative cerebrovascular disorders in the long-term period.Conclusion. When referring a patient with the presence of morphological manifestations of cerebral microangiopathy in the form of the leukoaraiosis phenomenon for cardiac surgery, these patients should be considered at risk requiring administration of the necessary set of measures for the prevention of long-term cerebral disorders.


2019 ◽  
Vol 34 (1) ◽  
pp. 92-97
Author(s):  
Yu. M. Portnov ◽  
S. E. Semenov ◽  
I. D. Syrova ◽  
I. V. Sigitov

Aim. To assess the preoperative morphological state of the brain and the state of cerebral circulation in patients referred for coronary bypass surgery to identify predictors of long-term cerebral disorders.Material and Methods. The study included 33 male patients, divided into 2 groups according to the presence or the absence of distant neurological complications 5 years after surgery. All patients underwent non-contrast computed tomography of the brain and perfusion computed tomography. Computed tomography was repeated 5 years after surgery.Results. The perfusion indices in all measurement zones in patients of the two groups did not significantly differ. Significant differences in width of the third ventricle and ventricular-cranial index between patients of groups 1 and 2 were not identified. The incidence rates of leukoaraiosis significantly differed: leukoaraiosis was detected significantly more frequently in group 2 (78% of cases) than in patients of group 1 (31%), p=0.0455.Discussion. The dimensions of the brain cavity system and the preoperative state of the microcirculatory blood flow were not predictors of long-term postoperative neurological disorders. Five years after surgery, patients of group 2 showed clinical and morphological signs of past ischemic changes, which were not detected in patients of group 1 suggesting that leukoaraiosis was an unfavorable prognostic indicator of postoperative cerebrovascular disorders in the long-term period.Conclusion. When referring a patient with the presence of morphological manifestations of cerebral microangiopathy in the form of the leukoaraiosis phenomenon for cardiac surgery, these patients should be considered at risk requiring administration of the necessary set of measures for the prevention of long-term cerebral disorders.


2010 ◽  
Vol 24 (4) ◽  
pp. 249-252 ◽  
Author(s):  
Márk Molnár ◽  
Roland Boha ◽  
Balázs Czigler ◽  
Zsófia Anna Gaál

This review surveys relevant and recent data of the pertinent literature regarding the acute effect of alcohol on various kinds of memory processes with special emphasis on working memory. The characteristics of different types of long-term memory (LTM) and short-term memory (STM) processes are summarized with an attempt to relate these to various structures in the brain. LTM is typically impaired by chronic alcohol intake but according to some data a single dose of ethanol may have long lasting effects if administered at a critically important age. The most commonly seen deleterious acute effect of alcohol to STM appears following large doses of ethanol in conditions of “binge drinking” causing the “blackout” phenomenon. However, with the application of various techniques and well-structured behavioral paradigms it is possible to detect, albeit occasionally, subtle changes of cognitive processes even as a result of a low dose of alcohol. These data may be important for the consideration of legal consequences of low-dose ethanol intake in conditions such as driving, etc.


Author(s):  
Peter R. Breggin

BACKGROUND: The vaccine/autism controversy has caused vast scientific and public confusion, and it has set back research and education into genuine vaccine-induced neurological disorders. The great strawman of autism has been so emphasized by the vaccine industry that it, and it alone, often appears in authoritative discussions of adverse effects of the MMR and other vaccines. By dismissing the chimerical vaccine/autism controversy, vaccine defenders often dismiss all genuinely neurological aftereffects of the MMR (measles, mumps, and rubella) and other vaccines, including well-documented events, such as relatively rare cases of encephalopathy and encephalitis. OBJECTIVE: This report explains that autism is not a physical or neurological disorder. It is not caused by injury or disease of the brain. It is a developmental disorder that has no physical origins and no physical symptoms. It is extremely unlikely that vaccines are causing autism; but it is extremely likely that they are causing more neurological damage than currently appreciated, some of it resulting in psychosocial disabilities that can be confused with autism and other psychosocial disorders. This confusion between a developmental, psychosocial disorder and a physical neurological disease has played into the hands of interest groups who want to deny that vaccines have any neurological and associated neuropsychiatric effects. METHODS: A review of the scientific literature, textbooks, and related media commentary is integrated with basic clinical knowledge. RESULTS: This report shows how scientific sources have used the vaccine/autism controversy to avoid dealing with genuine neurological risks associated with vaccines and summarizes evidence that vaccines, including the MMR, can cause serious neurological disorders. Manufacturers have been allowed by the US Food and Drug Administration (FDA) to gain vaccine approval without placebo-controlled clinical trials. CONCLUSIONS: The misleading vaccine autism controversy must be set aside in favor of examining actual neurological harms associated with vaccines, including building on existing research that has been ignored. Manufacturers of vaccines must be required to conduct placebo-controlled clinical studies for existing vaccines and for government approval of new vaccines. Many probable or confirmed neurological adverse events occur within a few days or weeks after immunization and could be detected if the trials were sufficiently large. Contrary to current opinion, large, long-term placebo-controlled trials of existing and new vaccines would be relatively easy and safe to conduct.


TAPPI Journal ◽  
2016 ◽  
Vol 15 (9) ◽  
pp. 581-586 ◽  
Author(s):  
RICARDO B. SANTOS ◽  
PETER W. HART ◽  
DOUGLAS C. PRYKE ◽  
JOHN VANDERHEIDE

The WestRock mill in Covington, VA, USA, initiated a long term diagnostic and optimization program for all three of its bleaching lines. Benchmarking studies were used to help identify optimization opportunities. Capital expenditures for mixing improvement, filtrate changes, equipment repair, other equipment changes, and species changes were outside the scope of this work. This focus of this paper is the B line, producing southern hardwood pulp in a D(EP)DD sequence at 88% GE brightness. The benchmarking study and optimization work identified the following opportunities for improved performance: nonoptimal addition of caustic and hydrogen peroxide to the (EP) stage, carryover of D0 filtrate to the (EP) stage, and carryover of (EP) filtrate to the D1 stage. As a result of actions the mill undertook to address these opportunities, D0 kappa factor decreased about 5%, sodium hydroxide consumption in the (EP) stage decreased about 35%, chlorine dioxide consumption in the D1 stage decreased about 25%, and overall bleaching cost decreased about 15%.


2004 ◽  
pp. 406-412
Author(s):  
Paul Okunieff ◽  
Michael C. Schell ◽  
Russell Ruo ◽  
E. Ronald Hale ◽  
Walter G. O'Dell ◽  
...  

✓ The role of radiosurgery in the treatment of patients with advanced-stage metastatic disease is currently under debate. Previous randomized studies have not consistently supported the use of radiosurgery to treat patients with numbers of brain metastases. In negative-results studies, however, intracranial tumor control was high but extracranial disease progressed; thus, patient survival was not greatly affected, although neurocognitive function was generally maintained until death. Because the future promises improved systemic (extracranial) therapy, the successful control of brain disease is that much more crucial. Thus, for selected patients with multiple metastases to the brain who remain in good neurological condition, aggressive lesion-targeting radiosurgery should be very useful. Although a major limitation to success of this therapy is the lack of control of extracranial disease in most patients, it is clear that well-designed, aggressive treatment substantially decreases the progression of brain metastases and also improves neurocognitive survival. The authors present the management and a methodology for rational treatment of a patient with breast cancer who has harbored 24 brain metastases during a 3-year period.


Sign in / Sign up

Export Citation Format

Share Document